Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis

BMC Health Services Research

Peter von Dadelszen⁴  Vyta M Senikas⁵  Melanie Basso¹  Diane Sawchuck⁴  Anne R Synnes²  Marie Kruse³  Craig Mitton⁶  Laura A Magee⁷  Celeste D Bickford⁶ 

[1] Children’s & Women’s Health Centre of British Columbia, Perinatal Health Program, Vancouver, Canada;Department of Pediatrics, Division of Neonatology, Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada;Danish Institute for Health Services Research, Copenhagen, Denmark;Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of British Columbia, Vancouver, Canada;Faculty of Medicine, McGill University, Montreal, Canada;School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada;Department of Medicine, Division of Internal Medicine, University of British Columbia, Vancouver, Canada

关键词: Cost-effectiveness;    Cerebral palsy;    Preterm birth;    Fetal neuroprotection;    Magnesium sulphate;   

Others  :  1134434
DOI  :  10.1186/1472-6963-13-527

 received in 2013-05-10, accepted in 2013-12-05,  发布年份 2013

【 摘 要 】

Background

The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32⁺⁰ weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection.

Methods

Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective. In addition, two separate measures of effectiveness were utilized: cases of cerebral palsy (CP) averted and quality-adjusted life years (QALYs).

Results

From a health system and a societal perspective, respectively, a savings of $2,242 and $112,602 is obtained for each QALY gained and a savings of $30,942 and $1,554,198 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is imminent. From a health system perspective and a societal perspective, respectively, a cost of $2,083 is incurred and a savings of $108,277 is obtained for each QALY gained and a cost of $28,755 is incurred and a savings of $1,494,500 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is threatened.

Conclusions

Administration of magnesium sulphate to patients in whom preterm birth is imminent is a dominant (i.e. cost-effective) strategy, no matter what cost perspective or measure of effectiveness is used. Administration of magnesium sulphate to patients in whom preterm birth is threatened is a dominant strategy from a societal perspective and is very likely to be cost-effective from a health system perspective.

【 授权许可】

   
2013 Bickford et al.; licensee BioMed Central Ltd.

【 图 表 】

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